Modern emergency medical practice strives to provide the most advanced and timely diagnosis and treatment as possible, since time factor is often crucial to the successful clinical outcomes.
One of the sudden critical health crises is cardiac ventricular fibrillation (‘VF’) which is invariably fatal unless treated promptly. The way to treat VF is to administer an electric pulse to the heart which shocks the heart muscle and induces it to revert to its normal contraction pattern. This procedure is called defibrillation and is effected by a device called ‘defibrillator’.
There are two types of defibrillators: the external and internal, the latter implanted into a patient's body.
External defibrillators are relatively large and contain a large battery pack and a high voltage generator. The weight of an external defibrillator is in the order of 2-7 lbs (1-3.5 kg). The generated high voltage pulse is administered to a patient via two large conductive paddles positioned on his chest and side, respectively.
An implantable defibrillator, being very small and light is permanently surgically implanted into a patient's body, and its electrical lead is inserted directly into the heart. The outer case of the device is made of metal and acts as a second electrode to complete the path of electrical current through the heart. The implantable defibrillators are used in patients with chronic cardiac disease and their implantation requires a major surgical procedure in a hospital setting.
In an emergency situation providing an external defibrillator in a timely manner can be problematic, since due to its size and weight it presents a carry challenge to first-response medical personnel who are frequently over-burdened with other equipment and may not have an external defibrillator in their medical kit. Also, some first-responders, such as for example motorcycle patrol policemen may not carry a defibrillator due to the limited carry space on their motorcycles. Waiting for the response team with a defibrillator to arrive may spell death for the VF sufferer, as the chances of survival diminish at the rate of 10% per minute delay. On the other hand, to implant a small defibrillator under non-hospital conditions and within an extremely brief ‘window of opportunity’ is not feasible.
Still, having a defibrillation capability ‘on-hand’ in an emergency is very desirable in view of its potential in saving lives.
Through experimentation, I have discovered that when a mammalian epidermis is bypassed, the body electrical impedance is reduced by an order of magnitude. This enables a multifold decrease in the energy required for external defibrillation, bringing it close to the energy provided by implantable defibrillators, and, in turn, results in a much smaller external defibrillator.